螺旋断层放疗45例鼻咽癌近期临床观察

Short-term clinical observation of tomotherapy for 45 nasopharyngeal carcinoma patients

目的:探讨螺旋断层放疗鼻咽癌的经验及近期临床观察结果。方法:观察2007年9月-2008年9月我院收治的经螺旋断层放疗的鼻咽癌患者45例,鼻咽癌原发病灶(pGTVnx)及转移性淋巴结(GTVnd)处方剂量70～76Gy/32～33F,高危区(CTV1)60～66Gy/32～33F,低危区(CTV2)49.5～56.1Gy/32～33F。根据RTOG/EORTC标准评价急性反应。结果:随访时间1～12个月,中位随访时间6个月。皮肤急性反应发生率1级75.6%、2级17.8%、3级2.2%;口腔黏膜急性反应发生率1～2级97.8%,3级2.2%;急性腮腺损伤发生率1级48.9%,2级46.7%,无3级损伤。鼻咽原发灶和颈部转移淋巴结消退率分别为88.9%和90.0%,无肿瘤进展及局部复发。结论:鼻咽癌螺旋断层放疗严重急性反应发生率低,且治疗时间短。

Objective： To evaluate the preliminary clinical results of tomotherapy for 45 nasopharyngeal carcinoma （ NPC ） patients. Methods： Between September 2007 and September 2008, 45 newly diagnosed NPC patients were treated with tomotherapy at the dose of 70-76Gy/32-33F for the gross tumor volume （ pGTVnx ） and positive lymph nodes （ GTVnd ）, and 60-66Gy/32-33F for the high risk clinical target volume （ CTV1 ）, and 49.5-56.1Gy/32-33F for the low risk clinical target volume （ CTV2 ）, respectively. Acute lesions were evaluated with the RTOG/EORTC criteria. Results： The median followup time was 6 months. The grades 1-3 of acute toxicity to skin were 75.6%, 17.8% and 2.2%, respectively. The grades 1-2 and 3 of acute toxicity to mucous membrane of mouth were 97.8% and 2.2%, respectively. The grades 1 and 2 of acute toxicity to xerostomia were 48.9% and 46.7%, respectively. None of grade 3 acute toxicity was detected. The remission rate of primary lesion and positive lymph nodes was 88.9% and 90.0%, respectively. No PD or local recurrence was detected. Conclusion： NPC TomoTherapy has a low incidence of severe acute toxicity and a short therapeutic time.